Background: The childhood mortality rate in Nigeria continued to remain high. Unfortunately, information on the regional trajectories, progress, and sociodemographic determinants of childhood mortality in Nigeria are not readily available. The objectives of this study are to describe the childhood mortality trajectory in Nigeria, assess progress made toward achieving the 2006 child health policy targets, and determine the peculiar factors associated with childhood mortality in Nigeria regions. Materials and Methods: Birth history data from the Nigeria Demographic and Health Surveys for 1990, 2003, 2008 and 2013 were analysed. Childhood mortality levels were derived using indirect demographic techniques. Locally weighted scatterplot smoothing technique was employed to ascertain the childhood mortality trajectory. Weibull frailty models were fitted to determine the influence of unmeasured variables and factors associated with childhood death in each region. Results: Childhood mortality stagnated at 207/1000 live births until the year 2000, after which there was a linear decline to 137/1000 live births in 2010 at an annual rate of 4.91% (confidence interval: 4.52–5.29). The rate of decline was least in the South West (2.97%) and highest in the North Central (7.40%). Multivariate analysis revealed that unmeasured community factors played significant roles in North East and North West. Birth interval < 24 months, multiple births, and young maternal age were risk factors across all regions. Conclusions: Nigeria child survival dynamics differ between the Northern and Southern regions and rural and urban locations. Only the North Central and South-South regions are on course to achieve the 2006 targets for under-five mortality reduction. Multiple birth, short birth intervals, and young maternal age at child's birth were risk factors for childhood mortality in the six geo-political regions in Nigeria.

[ABSTRACT]  [FULL TEXT]  [PDF]  [Mobile Full text]  [EPub] [CITATIONS]

Background: Serum electrolyte disturbances are common in under-five children with acute diarrhea but may remain unrecognized, resulting in morbidity and sometimes mortality. Objective: The objective was to assess the type and prevalence of electrolyte abnormalities in severely dehydrated under-five children with acute diarrhea at the point of hospital admission. Patients and Methods: This was a descriptive, hospital-based cross-sectional study of children aged 1–59 months with severe dehydration due to acute diarrhea. Serum electrolyte profiles were determined. Outcome measures such as death or survival were recorded. The co-morbidities were also recorded. Results: Of the 63 children studied, 50 (79.3%) subjects were aged below 36 months. Vomiting and fever accompanied diarrhea in 33 (52.4%) of the cases. The frequencies of the various types of dehydration were hyponatremic in 41 (65.1%), isonatremic in 17 (27.0%), and hypernatremic in 5 (7.9%) of the children. Of the electrolyte abnormalities observed, hyponatremia and hypokalemia ranked first and second in frequency, respectively. The overall case fatality rate was 6 (9.5%). All the patients that died were aged below 24 months. 5 (83.3%) of the 6 patients that died had a combination of metabolic acidosis in association with one or two other electrolyte abnormalities. 6 (10.5%) of the 57 patients that survived had normal serum electrolyte profiles. Conclusion: Hyponatremia, hypokalemia, and metabolic acidosis were the leading electrolyte abnormalities in acute diarrheal illnesses and were responsible for most diarrhea-related deaths, particularly when measles or bronchopneumonia is a co-morbid condition.

[ABSTRACT]  [FULL TEXT]  [PDF]  [Mobile Full text]  [EPub] [CITATIONS]

Geriatric medicine as a speciality is just evolving in Africa. There is scanty data on the mortality and associated factors among elderly patients admitted to the hospital medical wards in Africa. The objective of this review was to identify, describe, and analyze systematically the available studies on all-cause mortality and associated factors among elderly patients admitted to the medical wards of a hospital in Africa. Online and hand-based systematic searches were conducted for literature (primary and secondary) describing the mortality in elderly patients admitted to the medical wards of a hospital in Africa. These included original research, review articles, proceedings, and transactions from 1969 to 2014. All identified studies were screened using the Population, Intervention, Comparison, and Outcomes criteria. Five studies describing 3427 hospitalized elderly patients reported 773 deaths giving an unadjusted proportion of admissions which resulted in in-hospital deaths of 22.6% (range: 6.8–44.7%). This was higher among the males (38.8–48.0%) compared with the females (29.4–40.7%). There was no significant association between the age and mortality. Mortality was high among patients who had stroke, meningitis, septicaemia, renal failure, chronic liver disease, chronic obstructive pulmonary disease, severe asthma, and heart failure. High mortality was associated with high serum creatinine and urea, tachycardia, reduced length of stay from admission to death, and low serum protein. In conclusion, the few available data showed high unadjusted all-cause mortality among hospitalized elderly patients in Africa. More studies are needed in Africa to quantify this health burden and identify the major factors causing the high mortality in elderly patients.

[ABSTRACT]  [FULL TEXT]  [PDF]  [Mobile Full text]  [EPub] [CITATIONS]

[FULL TEXT]  [PDF]  [Mobile Full text]  [EPub] [CITATIONS]

[FULL TEXT]  [PDF]  [Mobile Full text]  [EPub] [CITATIONS]

Background: Sexual abuse of adolescent girls is a menace that has been reported globally, and it is increasing at an alarming rate. Objectives: The study assessed experiences of sexual harassment (SH), sexual exploitation (SE), and rape among school adolescent girls in Ife/Ijesa Zone of Osun State, Nigeria. It also assessed the perpetrators, settings of the abuse, and reactions of survivors to sexual abuse. Latent variables underlying revictimization during adolescent years were also explored. Methods: Cross sectional design was employed with qualitative and quantitative components. Two hundred twenty four adolescent girls from two public high schools were selected using cluster sampling technique. Quantitative data were collected using a semi structure questionnaire while qualitative data were collected using Focus Group Discussion Guide (FGDG). Institutional Review Board approval was received for the study. Results: Quantitative findings showed that 55.5% experienced SH and 23.7% experienced SE while 20.8% experienced rape. Three factors that were extracted using factor analysis were labeled as "forceful sexual interaction," "romance," and "actual sexual intercourse." Perpetrators of rape and SH were mostly male friends (69% and 50% respectively) while perpetrators of SE were mostly sexual partners (91%) which some of girls referred to as "aristos" in FGD. The mostly reported setting for various acts of sexual abuse was the perpetrators' house (rape 3%; SH 7%; SE 6%) and many of the survivors reported they did nothing about the abuse (rape 1%; SH 1%; SE 1%). However, all those who were sexually abused as children experienced high level of sexual abuse in adolescent stage. The FGD revealed that perpetrators of sexual abuse were mostly teachers, sexual partners, and peers while the bush path was mentioned as setting for rape contrary to data from the questionnaire. Conclusion: Sexual abuse educational intervention should focus more on male friends and sexual partners as perpetrators; the perpetrator's house as the settings for abuse; the necessity to report; and romance and force as elements of sexual abuse.

[ABSTRACT]  [FULL TEXT]  [PDF]  [Mobile Full text]  [EPub] [CITATIONS]

Background: Adolescence marks the beginning of transition between childhood and adulthood. However, inadequate knowledge about this transition remains a challenge among this group. Objective: This study was therefore designed to investigate the knowledge of puberty, sexually transmitted infections (STIs), and sexual behavior among very young female adolescent students aged 10-14 years in Agbor metropolis, Nigeria. Methods: A qualitative and quantitative cross-sectional study was conducted among female adolescent students (10-14 years). The discussants were grouped into ages 10-12 years and 13-14 years. A total of four focus group discussions were conducted among the two groups in two government secondary schools in the study area, while a semi-structured questionnaire which comprised sociodemographic characteristics, knowledge of puberty, STIs, and sexual behavior was used to collect the quantitative data. The qualitative data were analyzed thematically for themes and content, while the quantitative data were analyzed using SPSS Version 15.0. Results: The result shows most of the respondents 96 (97.0%) have heard of puberty and were able to define puberty 82 (85.40%). Furthermore, majority of the respondents have heard of the word human immunodeficiency virus 95 (96.0%) and STI 60 (60.6%), but few 4 (4.0%) have heard of the word contraceptive. In addition, only 12 (12.10%) of the respondents have a boyfriend, out of which only 3 (3.0%) have had sex at the age of 9 and 11 years, respectively. Conclusions: The results shows some of the respondents are already sexually active at that young age, therefore more intervention programs targeting these group of students should be carried out regularly in schools nationwide.

[ABSTRACT]  [FULL TEXT]  [PDF]  [Mobile Full text]  [EPub] [CITATIONS]

Background: Air pollution is often perceived as an outdoor public health problem but the air in residential buildings, cars and offices can also be polluted. Indoor air pollution (IAP) is the presence of one or more contaminants in the indoor environment that has a degree of human health risk. IAP is a risk factor for respiratory tract infection and is associated with increased risk morbidity and mortality in developing countries. Objective: The present study determined the relationship between awareness of IAP and prevalence of respiratory symptoms. Methods: This was a descriptive cross-sectional study. Respondents were selected using a multistage sampling technique. Data were collected using structured questionnaires with the aid of interviewers. Results: Two hundred and thirty-nine (95.6%) of 250 who were given questionnaires responded. One hundred and fifty (62.8%) of respondents were aware of IAP. The major source of their information was through the radio in 57 (23.8%). One hundred and four (43.5%) prepare food on the corridor with cooking with a kerosene stove, and 211 (88.3%) were using mosquito coil. Shortness of breath was reported by 49 (20.5%) while 25 (10.5%) expectorated phlegm. Respondents with exposure to tobacco smoke in the indoor environment had a 12-fold likelihood of having phlegm and an 8-fold likelihood of having shortness of breath. Conclusion: The level of awareness of IAP by the respondents was low in this study. Indoor smoking was a major determinant of respiratory symptoms. There is thus, a need for widespread health promotion to raise awareness about IAP and its effects.

[ABSTRACT]  [FULL TEXT]  [PDF]  [Mobile Full text]  [EPub] [CITATIONS]

Background: Evaluation of effectiveness of polio immunization has to be monitored continuously, particularly in endemic countries so that the immunity status can be precisely and effectively established. The aim of the present study was to determine the seroprevalence of poliovirus antibody in Zamfara State, Nigeria. Materials and Methods: This was a cross-sectional study of children aged 0–59 months. The children were randomly selected across the state. Blood samples collected from the children were tested for the presence of antibodies to poliovirus. Results: Blood samples from 63 (78.8%) of the 80 children had antibodies to all the three poliovirus serotypes. Seventy-five (93.8%), 68 (85.0%), and 75 (93.8%) of blood samples had antibodies to poliovirus serotypes 1, 2, and 3 respectively. All (100.0%) blood samples from children in the age group of 48–59 months tested positive for poliovirus. All (100.0%) the females had poliovirus antibody. In general, poliovirus antibody prevalence increased with increase in oral polio vaccine doses received. Urban children had higher poliovirus antibody prevalence of 81.0%, higher than their rural counterpart. Children whose fathers were educated up to tertiary level had 100.0% poliovirus antibody. There was no association among seroprevalence of poliovirus antibody and number of vaccine doses received and location of child's place of residence. Prevalence of poliovirus antibody was statistically significant based on age and father's educational level (χ^[2] = 0.1360, χ^[2] = 0.2923, respectively, P < 0.05). Conclusion: For the state to sustain the gains made in interrupting poliovirus transmission, more work need to be done so as to close the gap observed in the study.

[ABSTRACT]  [FULL TEXT]  [PDF]  [Mobile Full text]  [EPub] [CITATIONS]

Background: HIV/AIDS Counseling and Testing (HCT) is an effective tool in HIV prevention and control. However, perceived hindrances may limit the utilization of HIV Counseling and Testing (HCT) services, particularly among high-risk groups. Therefore, this study assessed perceived hindrances and factors influencing the acceptability of (HCT) among commercial drivers. Methods: This was a cross-sectional survey of commercial drivers in Ife Central Local Government Area. Data were analyzed using Statistical Package for Social Sciences for Windows version 20. The dependent variable for the multiple regressions was commercial drivers willingness to uptake free HCT services in their motor parks, while independent variables were their age, marital status, and the level of education. Results: Three-hundred commercial drivers were surveyed. 76 (25.3%) of respondents had previously undergone HIV test. 184 (61.3%) of the 300 respondents were willing to uptake HCT services. Perceived possible hindrances to HCT uptake were fear of a positive HCT test by 259 (86.3%), stigmatization by 260 (86.7%), lack of in-depth knowledge about HCT 258 (86.0%), and confidentiality concerns by 267 (89.0%) while 151 (50.3%) perceived poor access to HIV testing services as a hindrance. Multivariate analysis revealed that drivers aged 30–39 years were twice more likely to accept HCT service compared to their 20–29-year-old colleagues. Car drivers were twice more likely to accept HCT compared to bus drivers, whereas drivers with secondary education were four times less likely to accept HCT compared with their colleagues with tertiary education. Conclusion: This study revealed that a high proportion of drivers was willing to uptake HCT services. The introduction of free HCT education and services at motor parks would, therefore, enhance HCT uptake.

[ABSTRACT]  [FULL TEXT]  [PDF]  [Mobile Full text]  [EPub] [CITATIONS]